Lumbar decompression is a surgical procedure designed to alleviate pressure on the spinal cord or nerves caused by conditions like herniated discs, spinal stenosis, or degenerative changes. This pressure can result in symptoms such as persistent lower back pain, numbness, tingling, or weakness in the legs. By removing or reshaping bone, tissue, or disc material, lumbar decompression relieves this compression, restoring mobility and reducing discomfort.
Dr. Paul takes a highly patient-focused and personalized approach to lumbar decompression. He begins with a thorough evaluation, including imaging and physical exams, to confirm whether surgery is the most suitable option. When the procedure is appropriate, Dr. Paul carefully utilizes advanced techniques, often incorporating minimally invasive methods, to reduce scarring and speed up recovery.
Throughout the process, Dr. Paul ensures that his patients fully understand the procedure and what to expect before, during, and after surgery. His goal is not only to relieve pain but also to improve his patients’ quality of life by enabling them to return to daily activities with confidence. Dr. Paul’s commitment to precision care and patient education sets the foundation for a smooth recovery and long-term relief.
Approximate surgical times is 30 to 40 minutes for one level, 40 to 60 minutes for two levels, two or more hours if more levels are required. We must emphasize, these are approximate times.
These times are much higher if you have had prior surgery on your spine. We must emphasize that these are approximate times. These times are much higher if you have had prior surgery on your spine.
Remember, there is substantially more time involved in putting you to sleep, prepping and draping prior to surgery, and more time required to wake you up. As a result, many additional hours are required. Time required to go to sleep, wake and recover can vary from two to three hours. Most of the variability is in the post-anesthesia recovery unit.
Dr. Paul typically calls the waiting room to update a family member or friend about you briefly. Kevin will typically check on you in the recovery room and speak to the nurse and Dr. Paul about your recovery. Nursing will let your family know when they can see you.
Making arrangements before surgery helps ensure all necessary steps are taken and allows you to focus on recovery.
Information to help you arrive on time for your procedure and to better understand the process on procedure day.
After surgery, you can expect some pain. Your surgeon and the staff will use every reasonable measure to help.
Explore Dr. Paul’s approach to long-term recovery, focusing on tailored treatment plans and ongoing support.
The following are some of the more common risks associated with spine surgery. It is impossible to outline all potential risks, but we have attempted to do so in good faith. It has not been established as a legal protection for us, but rather to better inform you. Please read them thoroughly.
Infections are a known complication of lumbar surgery. Infection rates are more associated with smoking, poorly controlled diabetes, obesity, and other health factors. Less invasive and shorter procedures also have lower complication rates. Infections requiring additional surgery are extremely rare in Dr. Paul’s practice.
Bleeding can be a serious complication since blood accumulation can compress the spinal cord or nerve roots. For that reason, we require discontinuing blood thinners, some anti-inflammatories and all herbal medications.
Spinal Leaks are a known complication in spine surgery but typically can be managed. They occur approximately 3 to 5% of the time They can be the result of adherent bone, disc, ligament or scar tissue to the dura and the membrane surrounding your nerves or spinal cord. They are far more associated with revision surgery, severe nerve compression and advanced age. If this occurs, we typically repair the leak during your operation. You may be required to lay flat for a short period of time afterwards. Late presenting or persisting spinal leaks can require additional surgery. Spinal leaks typically do not affect long term outcomes.
Neuropraxia & Nerve Injury - Nerves under pressure can react with pain or increased weakness after being decompressed. These issues are expected and usually resolve with treatment or time. The goal of fusion is to realign and improve the position of the spine which can cause some nerves to be stretched and also induce typically temporary changes. Rarely, these changes are permanent As a precaution, Dr. Paul utilizes a state-of-the-art nerve and spinal cord monitoring system to avoid neurologic problems.
Non-Union - Not all fusions heal. Some heal as early as three months, but many take longer. Some fusions require a year to heal. Dr. Paul’s team gets x-rays regularly during the first year and meets with you to make sure the fusion is successful. Some fusions will require revision surgery to fix the problem.
Medical Complications related to the heart, lung and kidneys and other organs are also a possibility. Although shorter less invasive procedures are associated with lower complication rates, they can still occur. We work closely with your primary care doctor and other specialists to make sure your medical conditions are optimized prior to surgery.
Naturally, once anesthetics have worn off, pain will become increasingly evident in the areas involved in a surgical procedure. You may not have much incisional pain after surgery because local anesthesia is injected at the time of surgery. This will wear off in the evening. We recommend you use the pain medicine prescribed or muscle relaxant to avoid the potential for getting behind your pain.
Dr. Paul will prescribe painkillers, also known as analgesics, to reduce the discomfort of this post-surgical recovery period. Medications prescribed can range from over-the-counter NSAIDs (after the first five days) to potent prescription opioids, depending on the projected severity of pain. If you are or have undergone a fusion procedure, you should avoid NSAIDs for the first 6 weeks. Patients should take care to manage their dosing relative to the pain experienced. Opioids can usually be tapered off within the first two weeks of surgery. NSAIDs may be taken with protective measures for the gastrointestinal system, such as proton-pump inhibitors (PPIs) such as omeprazole, antacids such as TUMS, and bismuth salts such as Pepto Bismol to reduce the risk of ulcer formation.
Taking proper care of your incision is essential for healing. Follow these guidelines to ensure a smooth recovery:
Your incision may drain for the first week following surgery. This is normal and should decrease as you heal. Look out for concerning signs such as foul-smelling drainage or a very red ("tomato red") wound—these may indicate an infection and should be reported to your doctor.
If you cannot keep the wound dry in the shower, consider taking sponge baths until your postoperative visit.
It is very common to have increased pain at night and when you first get up out of bed. Any time you remain in one position for an extended period of time, the muscles may tighten and swell, and you can experience pain. As a result, transitioning can bring on pain. Transitioning includes lying to sitting, sitting to standing. Anticipate this and use medication appropriately and or take time to do these activities. Do not try to move quickly. You won’t do anything to harm your surgery but you may have an increase in pain. This will improve with time.
After your surgery, it’s important to follow these guidelines to ensure a smooth and successful recovery. Daily walking is highly encouraged as part of your healing process. Start with short distances and gradually increase both the distance and duration each day. If you need to climb stairs, you may do so as necessary, but take your time and avoid overexertion.
Please adhere to a 10-pound lifting limit until your follow-up appointment. Additionally, avoid bending or twisting at the waist, as these movements can strain your healing body. Driving is not permitted while you are taking pain medications or muscle relaxants, so plan accordingly.
Refrain from sexual activity for the first two weeks after surgery to allow your body adequate time to recover. If physical therapy is deemed necessary, it will be arranged during your first follow-up appointment to support your rehabilitation journey.
There are no post-operative restrictions in climbing or descending stairs.
You may experience mild to moderate discomfort when using stairs immediately after surgery, but this is normal and won’t harm your healing. Take your time and use handrails for support. Similarly, getting on and off the toilet may feel uncomfortable initially. For lower toilets, a raised toilet seat or grab bars can provide added comfort and stability. Remember to move carefully as your body adjusts during this recovery phase.
We often talk to patients about the first two weeks being the most difficult after a microdiscectomy. The first 2 days are the hardest in that 2 weeks. The more generally active you are the more the muscle soreness improves. Please do not just lay in bed.
In the early weeks, gradually increase activities. Remain on your feet for more extended periods and improve your walking distances. You may return to a sedentary job in as little as 1-3 weeks but with no bending, twisting, or lifting more than 10 pounds. Sit only in chairs with good lumbar support.
You may start a regular aerobic activity such as vigorous walking, Stairmaster, or low impact aerobic exercise classes if allowed after the first follow up appointment. This is typically within 2-3 weeks. Once you are off of any narcotic pain killers, you are free to drive from our standpoint.
Dr. Paul’s team rarely relies on braces or immobilization. As a result, we allow people to move sooner after surgery. This also helps to maintain strength and flexibility of your core and spine. If necessary, we typically order physical therapy after your 2-week visit with Kevin.
After the first six weeks, we typically decrease restrictions, and we allow for more bending or twisting as required for normal everyday activities.
We will often raise the lifting restriction to 30 to 40 pounds. You may return to light duty or physical labor if pain-free and allowed by your surgeon—with minimal bending or twisting. You may swim after six weeks. Continue your physical therapy exercise program. You may be shown specific therapeutic exercises at your 6-week visit.
The most dramatic changes will take place in the first 8-weeks post-op. Even if you experience some of your pre-op pain during this time you should not be too concerned. We follow our patients for a year after surgery knowing the nerves may take a long time to heal. Most feel significantly better after the first week or two.
You may travel by car for more than 3 hours in 2-3 weeks, but with frequent breaks. You may travel by plane in 2-weeks for trips less than 4 hours. After 6 weeks, you can resume all travel. You may drive as soon as you are off narcotic painkillers.
We strongly recommend implementing the use of myChart to contact the office. Our staff monitors the messages during business hours.